Yonsei Med J.  2018 Sep;59(7):865-871. 10.3349/ymj.2018.59.7.865.

C-Reactive Protein to Serum Albumin Ratio Is an Independent Predictor of All-Cause Mortality in Patients with ANCA-Associated Vasculitis

• Moon JS
• Ahn SS
• Park YB
• Lee SK
• Lee SW

• KMID: 2428913
• DOI: http://doi.org/10.3349/ymj.2018.59.7.865

Abstract

PURPOSE
We investigated whether C-reactive protein (CRP) to serum albumin ratio (CAR) could be an independent predictor of all-cause mortality in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).
MATERIALS AND METHODS
We retrospectively reviewed the medical records of 170 patients with AAV. We collected clinical and laboratory data. We also examined AAV-related and traditional risk factors of all-cause mortality. To assess the hazard ratios of variables, we performed univariable and multivariable Cox hazard model analyses.
RESULTS
The mean age was 55.0 years and 53 patients (31.2%) were male among 170 patients with AAV (88 microscopic polyangiitis, 43 granulomatosis with polyangiitis, and 39 eosinophilic granulomatosis with polyangiitis). ANCA was detected in 129 patients (75.9%). The initial mean CRP and serum albumin were 41.1 (mg/L) and 3.6 (g/dL), and the mean CAR at diagnosis was 14.8. The most common risk factor of mortality was hypertension (42.4%), followed by chronic kidney disease ≥stage 3 (25.9%). Fourteen patients (8.2%) died during the mean follow-up of 56.7 months. In both multivariable Cox hazard model analyses, CAR at diagnosis was identified as an independent predictor of all-cause of mortality comparable to diabetes mellitus (DM). Moreover, patients with CAR ≥10.35 and having DM exhibited a higher frequency of all-cause mortality than those without.
CONCLUSION
CAR at diagnosis can be an independent predictor of all-cause mortality, comparable to DM, the conventional risk factor of mortality.

Keyword

Antineutrophil cytoplasmic antibody; vasculitis; c-reactive protein; albumin; mortality

MeSH Terms

Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis*
Antibodies, Antineutrophil Cytoplasmic
C-Reactive Protein*
Diabetes Mellitus
Diagnosis
Eosinophils
Follow-Up Studies
Granulomatosis with Polyangiitis
Humans
Hypertension
Male
Medical Records
Microscopic Polyangiitis
Mortality*
Proportional Hazards Models
Renal Insufficiency, Chronic
Retrospective Studies
Risk Factors
Serum Albumin*
Vasculitis
Antibodies, Antineutrophil Cytoplasmic
C-Reactive Protein
Serum Albumin

Figure

• 

  Fig. 1 A predictor of all cause-mortality in ANCA-associated vasculitis patients. Patients with CAR ≥10.35 and having DM exhibited a higher frequency of all-cause mortality than those without in Kaplan-Meier survival analysis. ANCA, antineutrophil cytoplasmic antibody; CAR, C-reactive protein to serum albumin ratio; DM, diabetes mellitus.

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